Potential of essential oil combinations for surface and air disinfection.

In this study, it was aimed to develop a novel disinfectant from various essential oils containing active components with antimicrobial activity. The mixture of oregano, cinnamon and clove oils (1 : 1 : 1) with 10% oil concentration (SOM) was used as potential disinfectant on various areas and showed the highest antimicrobial activity among oil combinations tested. SOM reduced the numbers of total mesophilic aerobic bacteria (TMAB; 2·27 log CFU per 25 cm2 ) and Escherichia coli (4·60 log CFU per 25 cm2 ) under the detection limits. Application of SOM (1, 2, 3, 4 and 6%) into incubators reduced TMAB and mould-yeast counts of incubator air by 82·9 and 100% respectively. SOM application (3%) into ambient air also reduced its TMAB and mould-yeast counts by 92 and 84·6% respectively. While ethanol is commonly used for the disinfection of environments, equipment and surfaces, SOM is an important alternative that may also be used for the disinfection of various surfaces as well as air.

Variations of the celiac trunk and hepatic arteries: a study with 64-detector computed tomographic angiography.

OBJECTIVES: The aim of the present study was to evaluate variations in celiac trunk and hepatic artery with multi-detector computed tomography (MDCT). PATIENTS AND METHODS: Totally 820 patients who underwent angiography of the abdominal aorta were evaluated. Anatomical findings were grouped according to the Michels classification. RESULTS: Several variations and/or anomalies were noted in 33.2% of the patients (n=272). The most common abnormality was Michels type III (10.1%), followed by type V (7.3%), type II (4.7%) and others. Type X was not observed in our series. We have noted additional, previously unclassified variations in 12 cases (1.5%). CONCLUSIONS: Preoperative knowledge of variant anatomy may assist in the selection of treatment options and surgical planning, which in turn facilitates surgical dissection and helps avoiding iatrogenic injury. MDCT angiography allows detailed visualization of the vascular anatomy.

Risk factors and prevalence of urinary incontinence in postmenopausal women living in Turkey.

PURPOSE OF INVESTIGATION: To detect the prevalence, types and risk factors of urinary incontinence (UI) in postmenopausal women. METHODS: Three-hundred and thirty-three patients who were referred to our Menopause Clinic between August 2008 and May 2009 were included in the study according to the acceptance criteria. A detailed questionnaire was completed by the patients who were between 31-65 years of age. RESULTS: The mean age was 52.5 and the mean age at which menopause symptoms started was 45.8. The prevalence of urinary incontinence was found to be 45.6%. The most frequently seen UI type was mixed urinary incontinence (68.4%). Advanced age, vaginal delivery, high BMI and no hormone replacement therapy were regarded as significant risk factors. CONCLUSION: UI is a common problem influencing the social experience of postmenopausal women. The prevalence of UI was detected as 45.6% in our study. The quality of life in postmenopausal women can be augmentated by diagnosing the risk factors of UI and making an effort to improve the condition.

Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure.

AIM: Renal ultrasound (US) is the most appropriate method for imaging renal failure; however, considerable overlap in renal size and renal echogenicity exists between normally and abnormally functioning kidneys. We compared the sonographic features of kidneys in patients with renal failure to investigate the potential role of renal US to distinguish acute from chronic renal failure and assessed the diagnostic role of body surface area-corrected renal length compared to measured renal length. MATERIALS AND METHODS: We included 127 consecutive patients with serum creatinine levels higher than 3 mg/dl and 33 healthy volunteers. The subjects with acute renal failure (ARF) and chronic renal failure (CRF) were compared for renal length, parenchymal thickness, parenchymal echogenicity, distinctness of the corticomedullary junction, and the presence of stones and cysts. RESULTS: No significant differences in age, serum albumin, creatinine, weight, height, or gender distribution were found between patients with ARF and those with CRF, except in serum hemoglobin. The right and left kidney parenchymal thickness and renal length were significantly greater in ARF patients than in those with CRF (p < 0.0001). The mean parenchymal thickness and renal length were similar in ARF patients and the control group. Grade I hyperechogenicity was the most common finding during sonography. CONCLUSIONS: Renal length, parenchymal thickness, and echogenicity differed significantly between patients with acute and chronic renal failure. A renal US examination is still the most appropriate method for imaging renal failure and should be combined with other tests to distinguish acute from chronic renal failure.

Analysis of uterine rupture cases in Agri: a five-year experience.

INTRODUCTION: We attempted to establish the frequency of uterine rupture and to address etiological factors, complications, management and maternal and perinatal outcome of complete versus incomplete rupture, with the aim of proposing preventive measures. METHODS: The clinical records of uterine rupture cases managed at the Obstetrics and Gynecology Department of Agri Maternity and Children's Hospital in Turkey from June 2004 to June 2009 were analyzed retrospectively. RESULTS: There were 44 cases of ruptured uterus. Among 24,554 deliveries the total incidence of uterine rupture was 1/558 or 17%. The most common site for the location of rupture was the fundal region (36.36%) followed by the lower segment, isthmic and mixewd types, respectively. DISCUSSION: Prevention must necessarily include regular antenatal care and meticulous screening of high-risk patients. Improved organization and access to maternal care, decentralization of obstetric services into peripheral care units in villages to prevent home deliveries and good supervision during labor can reduce the incidence of this preventable obstetric catastrophe.

Homozygous FGF3 mutations result in congenital deafness with inner ear agenesis, microtia, and microdontia.

Homozygous mutations in the fibroblast growth factor 3 (FGF3) gene have recently been discovered in an autosomal recessive form of syndromic deafness characterized by complete labyrinthine aplasia (Michel aplasia), microtia, and microdontia (OMIM 610706 - LAMM). In order to better characterize the phenotypic spectrum associated with FGF3 mutations, we sequenced the FGF3 gene in 10 unrelated families in which probands had congenital deafness associated with various inner ear anomalies, including Michel aplasia, with or without tooth or external ear anomalies. FGF3 sequence changes were not found in eight unrelated probands with isolated inner ear anomalies or with a cochlear malformation along with auricle and tooth anomalies. We identified two new homozygous FGF3 mutations, p.Leu6Pro (c.17T>C) and p. Ile85MetfsX15 (c.254delT), in four subjects from two unrelated families with LAMM. The p.Leu6Pro mutation occurred within the signal site of FGF3 and is predicted to impair its secretion. The c.254delT mutation results in truncation of FGF3. Both mutations completely co-segregated with the phenotype, and heterozygotes did not have any of the phenotypic findings of LAMM. Some affected children had large skin tags on the upper side of the auricles, which is a distinctive clinical component of the syndrome. Enlarged collateral emissary veins associated with stenosis of the jugular foramen were noted on computerized tomographies of most affected subjects with FGF3 mutations. However, similar venous anomalies were also detected in persons with non-syndromic Michel aplasia, suggesting that a direct causative role of impaired FGF3 signaling is unlikely.

Evaluation of topical Dexmedetomidine administration in postlaminectomy epidural fibrosis rat model.

Epidural fibrosis is a challenging topic in spinal surgery. Numerous clinical and experimental studies have been focused on this issue to clarify problems faced in spinal procedures for the patient as well as the surgeon and find out new methodologies. Dense cytokines and growth factors which are released from inflammatory cells have been suggested to play a major role in the inception and progression of fibrosis. One of the most investigated and important actor in epidural fibrosis is assumed to be the transforming growth factor-1ß (TGF-1ß) formation. Studies showed that Dexmedetomidine (DEX) downregulates TGF-ß pathway with its anti-inflammatory and antioxidant effects. From this point of view, for the first time in the literature we try to observe if there will be an effect of topical DEX administration over epidural fibrosis in a rat model. We hypothesized that DEX might have preventive effects on epidural fibrosis via anti-inflammatory and antioxidant effects. Twenty-four adult male Wistar albino rats were randomly assigned to three groups (Topical DEX, Spongostan, Laminectomy). A total laminectomy was performed at the L3-L5 level and then the ligamentum flavum and epidural fat tissue were cleared away from the surgical site. Histopathological assessment was performed postoperatively after 4 weeks. Our study revealed that topical DEX administration may have effects on reducing epidural fibrosis. Topical DEX administration may be helpful in preventing epidural fibrosis after laminectomy in rats through multiple anti-inflammatory and antioxidant mechanisms as well as through TGF -1ß pathway.

Characterisation of lipid profiles in dogs with parvoviral enteritis.

OBJECTIVE: To characterise the lipid profiles in dogs with parvoviral enteritis. METHODS: Blood was collected before treatment from 30 dogs that fulfilled the criteria for severe sepsis including hypo- or hyperthermia, hypotension, leucopenia, thrombocytopenia and evidences of organ dysfunction. Canine parvovirus was detected by haemagglutination and indirect fluorescence antibody tests in the faeces. Twenty control dogs were also enrolled on the basis of normal physical examination results, complete blood count and serum biochemistry profiles. RESULTS: Tachycardia, tachypnoea, hypotension, leucopenia, thrombocytopenia and increased serum markers of tissue injury (alanine aminotransferase, creatinine kinase myocardial isoenzyme [CK-MB], blood urea nitrogen and creatinine) were observed in dogs with parvoviral enteritis. Serum total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were lower, but serum triglyceride level was higher in dogs with parvoviral enteritis than those in control dogs (P<0.001). Circulating tumour necrosis factor alpha correlated negatively with total cholesterol (r=-0.979; P<0.001) but positively with triglyceride (r=0.953; P<0.001) in dogs with parvoviral enteritis. Serum total cholesterol and high-density lipoprotein cholesterol levels were lower in non-survival (n=9) dogs than in survival dogs (n=21, P<0.001). CLINICAL SIGNIFICANCE: Serum total cholesterol and high-density lipoprotein cholesterol levels decreased, but serum triglyceride level increased in dogs with parvoviral enteritis. Low serum total cholesterol and high-density lipoprotein cholesterol levels may be used as an index of the severity of parvoviral enteritis.

Outbreak of botulism in a dairy herd in Turkey.

In this study, the clinical findings and results of haematological and biochemical analyses of 26 cattle with botulism were evaluated. The most important clinical signs in the affected cattle included: decreased appetite, ataxia, difficulty to rise, loss of tongue tone, salivation and bradycardia. A definitive diagnosis of botulism was based on demonstration of the preformed toxin in ruminal and intestinal contents and feed materials including poultry litter, by mouse inoculation test. This study is the first confirmation, by direct toxin isolation, of Clostridium botulinum type C and Clostridium botulinum type D in cattle, in Turkey.

Cerebral alveolar echinoccosis mimicking primary brain tumor.

We present a case of cerebral infestation by Echinococcosis multilocularis mimicking an infiltrative primary brain tumor. A heavily calcified mass invading the midbrain enhanced in a cauliflower-like fashion with small peripheral nodules present on MR imaging. Perfusion-weighted MR imaging revealed low relative cerebral blood volume within the calcified lesion and peripheral hyperemia. Single-voxel proton MR spectroscopy with an echo time of 135 milliseconds was normal.

The dome procedure: a new technique for the reconstruction of the umbilicus.

PURPOSE: The absence of the umbilicus is, in essence, an aesthetic deformity of the abdominal wall. The goal of reconstructing the umbilicus is to obtain a natural, three-dimensional appearance. In this study, we present a new technique called the "dome procedure" for the reconstruction of the umbilicus. METHODS: This procedure can be applied under local anaesthesia on an outpatient basis and the drawing of the design is simple. The technique was applied to six patients who presented with an absence of the umbilicus following repair of a large incisional and umbilical hernia. RESULTS: No major or minor complications were encountered. Patient satisfaction was high after surgical intervention. CONCLUSIONS: The dome procedure, which enables the umbilicus to have a natural appearance with sufficient depression and normal-appearing wrinkles, is simple, easy to perform, and safe.

Lower recurrence rate with full-thickness mesh fixation in incisional hernia repair.

PURPOSE: To share the lower recurrence rate achieved during long-term follow-up by repairing incisional hernias (IHs) with full-thickness fixation of onlay mesh. METHODS: We retrospectively analyzed 196 IH cases operated on by the same surgeon between 2002 and 2013. After exclusions (unrelated death, lack of follow-up), 154 cases were included. Abdominal examination findings, recurrence dates (if accessible), and imaging results were obtained from computer records and evaluated. Intraoperatively, all hernial sac adhesions were separated to reveal the anterior abdominal wall, and full-thickness suspension sutures were placed 6-8 cm lateral to the fascial edge at 2-cm intervals, excluding the peritoneum. The primary fasciae were closed, suspension sutures were passed through the mesh holes, and the mesh was fixed as an onlay, leaving no space between the fasciae. RESULTS: In total, 154 subjects with IHs were analyzed: 107 (69.5%) females and 47 (30.5%) males. The mean patient age was 52.60 years [standard deviation (SD) 11.24 years], and the mean fascial defect diameter was 77 cm(2). The average operation time was 128 min (SD 42.5 min), and the average patient follow-up time was 54 months (SD 22.8 months). Eight (5.2%) patients developed recurrences after full-thickness mesh fixation, and ten subjects (6.5%) had persistent pain in the operative area for longer than 3 months. CONCLUSIONS: Full-thickness mesh fixation mechanically supports the fascia, especially in the early postoperative period, and enables homogeneous fibrous healing in a wide area, preventing mesh migration; we believe that these attributes are crucial in reducing the IH recurrence rate.

Dual energy virtual CT colonoscopy with dual source computed tomography: initial experience.

PURPOSE: To describe the technique of DE MDCT colonoscopy and to assess its feasibility. MATERIALS AND METHODS: 8 patients were scanned with DSCT with a DE scan protocol and dose modulation software. Analysis was performed using dedicated DE software. Prone non-contrast images and DE supine images after contrast injection were obtained. RESULTS: DE colonoscopic images were successfully obtained in 7 patients, but the FOV did not cover all colonic segments in 1 patient, thus resulting in a technical success rate was 87.5 %. Streak artifacts were present in the pelvic region in 2 patients. Virtual unenhanced images and iodine map images were obtained for all patients. In 1 patient a polypoid non-enhancing structure was noted on the iodine map, and conventional colonoscopy revealed impacted stool. Enhancing rectal cancer in 1 patient was correctly shown on the iodine map. Iodine maps helped to differentiate stool fragments/retained fluid by the absence of enhancement when compared to prone CT images. The major advantage of DE colonoscopy was the lack of misregistration. CONCLUSION: DE MDCT colonoscopy is technically feasible and may obviate the need for unenhanced prone images. It may be possible to perform noncathartic DECT colonoscopy. The major limitation is the limited FOV of tube B. The dose should be optimized to reduce streak artifacts in the pelvic region.